Blue Cross Of California

California doctors on Thursday launched their broadest legal assault yet on managed care, accusing three of the biggest HMOs of conspiring to keep doctors' fees low, lying to doctors and patients about the quality of care members would receive, and attempting to illegally insert themselves into the doctor-patient relationship. In a lawsuit filed in U.S. District Court in San Francisco, the 30,000-member California Medical Assn.

WellPoint Health Networks Inc., one of California's biggest health insurers, said its Blue Cross of California unit will stop processing Medicare claims as of December. Blue Cross & Blue Shield United of Wisconsin said it won the contract from the U.S. government to take over after Blue Cross of California stops and will hire the 400 workers currently employed to administer the claims.

Last August, in an earlier column on differences over how much Blue Cross of California should pay hospitals for care of its 5.5 million members, I concluded, "These disputes are intensifying. Stay tuned." Matters have now reached an even more critical point.

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Blue Cross members who receive care at clinics owned by MedPartners Inc. can continue to see their regular doctors, despite a letter from the insurer last week saying that all patients would be switched to new physicians. The decision to allow members to see their MedPartners' doctors came at the behest of state regulators, who issued a cease-and-desist order Friday after the health insurer unilaterally assigned its 118,000 MedPartners enrollees to new physicians.

The conservator appointed by state regulators to run troubled MedPartners Provider Network Inc. said Blue Cross of California endangered the health of its 118,000 members by assigning them to new medical groups. Eugene Froelich said his office ordered doctors in the MedPartners network to continue to treat patients who need care but were removed from their rolls by Blue Cross.

State regulators on Friday ordered a major health insurer to stop moving its members out of financially troubled MedPartners Provider Network Inc. The Department of Corporations said it ordered Blue Cross of California not to transfer 120,000 members--now getting health care through MedPartners--to other medical providers. The state said it took the action to prevent disruption in patient care.

Blue Cross of California, a subsidiary of WellPoint Networks Inc., has been selected to provide managed care services to the United Food and Commercial Workers Union and Food Employers Benefit Fund of Southern California. Under the contract, effective Sept. 1, more than 80,000 members of the union and their dependents will have access to Blue Cross of California's provider network, with more than 40,000 health care professionals at 375 facilities throughout the state.

The Santa Monica-Malibu Unified School District has received a $516,600 grant from Blue Cross' California Endowment to fund an infant and family support project designed to link parents with social and medical resources.